Treatment of vision loss in giant cell arteritis

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7 Scopus citations


Opinion statement: If giant cell arteritis is suspected as a cause of visual loss, emergent management is necessary. Clinical suspicion should prompt the practitioner to obtain laboratory studies and initiate treatment prior to establishing the diagnosis. The evaluation includes immediate erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and complete blood count (CBC). Treatment begins with high-dose intravenous corticosteroids. We recommend intravenous methylprednisolone (250 mg every 6 h) for 3 to 5 days. During that time, a temporal artery biopsy should be performed for pathologic diagnosis. We also begin daily adjunctive aspirin orally. After the initial bolus of intravenous corticosteroids, therapy transitions to oral prednisone administered at 1 mg/kg per day until the activity of the disease process attenuates, as demonstrated by improvement in systemic symptoms and normalization of both ESR and CRP. This change usually occurs in the first 3 to 4 weeks. The patient should be followed closely, with therapy tapered as guided by systemic symptoms, ESR, and CRP. To maximize the use of remaining vision, appropriate patients should be referred to specialists for help with low-vision therapies, assistive devices, and precautions to protect the better-seeing eye.

Original languageEnglish (US)
Pages (from-to)84-92
Number of pages9
JournalCurrent Treatment Options in Neurology
Issue number1
StatePublished - Feb 2012

Bibliographical note

Funding Information:
The authors acknowledge support from an unrestricted grant from Research to Prevent Blindness (New York, NY) and the Lions Club of Minnesota.


  • Antiplatelet therapy
  • Aspirin
  • Diagnosis
  • Giant cell arteritis
  • Glucocorticoids
  • Methylprednisolone
  • Prednisone
  • Temporal artery biopsy
  • Therapy
  • Treatment
  • Vision loss


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